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Intake of Dietary Fiber, Fruits, and Vegetables and Risk of Diverticulitis.
Am J Gastroenterol. 2019 09; 114(9):1531-1538.AJ

Abstract

OBJECTIVES

Although low fiber intake has been considered a risk factor for diverticulitis, prospective evidence is limited in women despite having a disproportionate burden of disease, with little known about variation in the protective effects according to food sources. We assessed the associations of intakes of fiber and major food sources of fiber including fruits and vegetables with risk of diverticulitis in a large cohort of women.

METHODS

We followed 50,019 women in the Nurses' Health Study (1990-2014) who were aged 43-70 years and free of diverticulitis, cancer, and inflammatory bowel disease at baseline. Incident diverticulitis was identified through self-report with validity confirmed by review of medical records.

RESULTS

We documented 4,343 incident cases of diverticulitis, encompassing 1,106,402 person-years of follow-up. Compared with participants in the lowest quintile, the multivariable hazard ratio of diverticulitis in the highest quintile of total fiber intake was 0.86 (95% confidence interval: 0.78-0.95; P-trend = 0.002). Fiber from fruits and cereals, but not vegetables, was associated with a decreased risk of diverticulitis. Furthermore, intake of total whole fruit intake and specific fruits such as apples/pears and prunes were associated with reduced risk of diverticulitis with a multivariable hazard ratio for diverticulitis of 0.95 (0.92-0.98; P-trend < 0.001) for every serving increase of total whole fruit intake per day.

DISCUSSION

Higher intake of dietary fiber and fiber from different food sources, except for vegetable fiber, are associated with a lower risk of diverticulitis in women. A greater intake of whole fruit is also associated with reduced risk.

Authors+Show Affiliations

Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA. Division of Gastroenterology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA. Division of Gastroenterology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA. Division of Gastroenterology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA. Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA. Division of Gastroenterology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA. Division of Gastroenterology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA. Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA.Tufts University School of Medicine, Boston, Massachusetts, USA.Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA. Department of Medicine, Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.Division of Gastroenterology, University of Washington School of Medicine, Seattle, Washington, USA.Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA. Division of Gastroenterology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA. Department of Medicine, Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA. Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

31397679

Citation

Ma, Wenjie, et al. "Intake of Dietary Fiber, Fruits, and Vegetables and Risk of Diverticulitis." The American Journal of Gastroenterology, vol. 114, no. 9, 2019, pp. 1531-1538.
Ma W, Nguyen LH, Song M, et al. Intake of Dietary Fiber, Fruits, and Vegetables and Risk of Diverticulitis. Am J Gastroenterol. 2019;114(9):1531-1538.
Ma, W., Nguyen, L. H., Song, M., Jovani, M., Liu, P. H., Cao, Y., Tam, I., Wu, K., Giovannucci, E. L., Strate, L. L., & Chan, A. T. (2019). Intake of Dietary Fiber, Fruits, and Vegetables and Risk of Diverticulitis. The American Journal of Gastroenterology, 114(9), 1531-1538. https://doi.org/10.14309/ajg.0000000000000363
Ma W, et al. Intake of Dietary Fiber, Fruits, and Vegetables and Risk of Diverticulitis. Am J Gastroenterol. 2019;114(9):1531-1538. PubMed PMID: 31397679.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Intake of Dietary Fiber, Fruits, and Vegetables and Risk of Diverticulitis. AU - Ma,Wenjie, AU - Nguyen,Long H, AU - Song,Mingyang, AU - Jovani,Manol, AU - Liu,Po-Hong, AU - Cao,Yin, AU - Tam,Idy, AU - Wu,Kana, AU - Giovannucci,Edward L, AU - Strate,Lisa L, AU - Chan,Andrew T, PY - 2019/8/10/pubmed PY - 2020/3/21/medline PY - 2019/8/10/entrez SP - 1531 EP - 1538 JF - The American journal of gastroenterology JO - Am. J. Gastroenterol. VL - 114 IS - 9 N2 - OBJECTIVES: Although low fiber intake has been considered a risk factor for diverticulitis, prospective evidence is limited in women despite having a disproportionate burden of disease, with little known about variation in the protective effects according to food sources. We assessed the associations of intakes of fiber and major food sources of fiber including fruits and vegetables with risk of diverticulitis in a large cohort of women. METHODS: We followed 50,019 women in the Nurses' Health Study (1990-2014) who were aged 43-70 years and free of diverticulitis, cancer, and inflammatory bowel disease at baseline. Incident diverticulitis was identified through self-report with validity confirmed by review of medical records. RESULTS: We documented 4,343 incident cases of diverticulitis, encompassing 1,106,402 person-years of follow-up. Compared with participants in the lowest quintile, the multivariable hazard ratio of diverticulitis in the highest quintile of total fiber intake was 0.86 (95% confidence interval: 0.78-0.95; P-trend = 0.002). Fiber from fruits and cereals, but not vegetables, was associated with a decreased risk of diverticulitis. Furthermore, intake of total whole fruit intake and specific fruits such as apples/pears and prunes were associated with reduced risk of diverticulitis with a multivariable hazard ratio for diverticulitis of 0.95 (0.92-0.98; P-trend < 0.001) for every serving increase of total whole fruit intake per day. DISCUSSION: Higher intake of dietary fiber and fiber from different food sources, except for vegetable fiber, are associated with a lower risk of diverticulitis in women. A greater intake of whole fruit is also associated with reduced risk. SN - 1572-0241 UR - https://www.unboundmedicine.com/medline/citation/31397679/Intake_of_Dietary_Fiber_Fruits_and_Vegetables_and_Risk_of_Diverticulitis_ L2 - https://Insights.ovid.com/pubmed?pmid=31397679 DB - PRIME DP - Unbound Medicine ER -